Periodontics Therapy to Treat Gum Diseases

What does periodontics entail? Periodontics deals with studying the structure of the teeth and their surrounding structures; the prevention, diagnosis, and treatment of the inflammatory diseases that affect them. Periodontics focuses on preventing, diagnosing, and treating inflammatory diseases of the teeth and their surrounding structures (the gum and the bone).

Gingivitis, which is inflammation of the gum, is the mildest form of periodontal disease. It is caused by the build of food particles, plaque formation, and unhindered bacteria activity. The plaque, if not removed, hardens to form tartar which discolors the teeth and causes extensive damage not only to the gum but also to the teeth and bone. If not checked, gingivitis can lead to periodontitis, where pockets are formed caused by the pulling away of the gum and bone from the teeth. Unchecked periodontitis will cause symptoms of gingivitis such as:

• Loose tooth/teeth
• Subsequently tooth/teeth loss
• Pain
• Swollen and red gums
• Bleeding

The risk factors for gum diseases are:

• Poor oral hygiene (irregular brushing and flossing)
• Poor nutrition
• Age
• Smoking
• Medications
• Hormonal changes
• Systemic diseases like diabetes mellitus, and family history of the development of gingivitis.

Non-surgical management of gum diseases

Treatment of gum diseases depends on the stage of the disease at presentation and your preference. You can have either surgical or non-surgical management.

Non- surgical treatment of gum diseases includes dental cleaning and scaling, and root planing. In professional dental cleaning, the dentist's plaque and tartar are below and above the gum line. Scaling and root planning is a form of deep cleaning done under local anesthesia. During scaling, the dentist uses periodontal scalers (for supra-gingival use) and periodontal curettes (for both sub-gingival and supra-gingival use) for debridement. The dentist does root planning to smoothen the roots of the debrided teeth. The dentist can also use the ultrasound scaler (an electronic device for scaling and root planning). The ultrasound scaler releases air into the gum pockets to hinder the activities of anaerobic bacteria. As part of non-surgical therapy, the dentist can prescribe one or more oral antibiotics, enzyme suppressants, antibiotic gel, antibiotic microspheres, antiseptic chip, and antiseptic mouthwash. 

Surgical management of gum diseases

Surgical intervention is used when there is advanced periodontitis and extensive tissue damage. This includes bone and soft tissue grafts, flap surgery, and guided tissue regeneration. In flap surgery (pocket reduction surgery), the dentist pulls the gum back and removes the plaque and tartar. The gums are placed back on the tooth/teeth to fit correctly and reduce the size of the pockets to prevent the collection of food particles and further bacteria action. Bone and soft tissue grafting involve using natural bone (from the patient or a donor) or synthetic bone to replace the tissue eroded by bacteria action. Guided tissue regeneration is a form of biological engineering that causes the accelerated growth of gum and bone tissue.  

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